JAHA:肥厚性心肌病患者房颤消融治疗:策略、连续房性心动过速特点和长期结局

2021-01-18 MedSci原创 MedSci原创

AF消融对HCM患者的长期心律控制是有效的,特别是对阵发性AF患者进行肺静脉隔离治疗会取得良好的临床效果。AF消融后的ATs在HCM患者中很常见。

心房颤动(AF)在肥厚性心肌病(HCM)患者中很常见,并与患者临床状况恶化有关。射频消融是症状性AF已知的治疗方法,但在HCM中,复发性心房心律失常的特征和长期预后尚未明确。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员纳入了65名接受AF消融治疗的HCM患者(年龄为64.5±9.9岁,42名(64.6%)男性)。消融策略包括对所有患者进行肺静脉隔离,并在适当的情况下消融复杂分段性房性心动过速(AT)。

13例(20.0%)、51例(78.5%)和1例(1.5%)患者分别伴有阵发性、持续性AF和原发性AT。25例(38.4%)患者发生AT,总计54次ATs。

15例(23.1%)患者为稳定性AT,10例(15.3%)患者为不稳定性AT。经过1.9±1.2次消融治疗和48.1±32.5个月的随访,60.0%的患者证实无AF/AT复发。阵发性和持续性AF患者分别有84.6%和52.9%的患者没有复发(P<0.01)。24例(36.9%)患者仍需要抗心律失常药物治疗。

由此可见,AF消融对HCM患者的长期心律控制是有效的,特别是对阵发性AF患者进行肺静脉隔离治疗会取得良好的临床效果。AF消融后的ATs在HCM患者中很常见。

原始出处:

Leon Dinshaw.et al.Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy: Treatment Strategy, Characteristics of Consecutive Atrial Tachycardia and Long‐Term Outcome.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.017451

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    2021-01-21 小豁牙

    好文章

    0

  3. 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    2021-01-20 zhaohui6731
  4. 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style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918036, encodeId=624a918036fc, content=有梅斯医学真好。可惜我之前的账号没了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 19 13:10:00 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031345, encodeId=a6f810313451b, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Tue Jan 19 02:45:49 CST 2021, time=2021-01-19, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2079101, encodeId=5bc820e910122, content=<a href='/topic/show?id=8fdb542e29e' target=_blank style='color:#2F92EE;'>#房颤消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54272, encryptionId=8fdb542e29e, topicName=房颤消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Wed Sep 29 09:45:49 CST 2021, time=2021-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918740, encodeId=ef53918e40e1, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210124/2959859c08784950bc188459d8d7c2c1/3509ed0b3e3e4ca08f78e8a9232d2e4c.jpg, createdBy=24f61480129, createdName=小豁牙, createdTime=Thu Jan 21 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topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597758, encodeId=46ea159e7583b, content=<a href='/topic/show?id=28986582e02' target=_blank style='color:#2F92EE;'>#消融治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65827, encryptionId=28986582e02, topicName=消融治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f07818523366, createdName=zhishijing, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622467, encodeId=d420162246e16, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918036, encodeId=624a918036fc, content=有梅斯医学真好。可惜我之前的账号没了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 19 13:10:00 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031345, encodeId=a6f810313451b, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Tue Jan 19 02:45:49 CST 2021, time=2021-01-19, status=1, ipAttribution=)]
  6. 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topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597758, encodeId=46ea159e7583b, content=<a href='/topic/show?id=28986582e02' target=_blank style='color:#2F92EE;'>#消融治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65827, encryptionId=28986582e02, topicName=消融治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f07818523366, createdName=zhishijing, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622467, encodeId=d420162246e16, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918036, encodeId=624a918036fc, content=有梅斯医学真好。可惜我之前的账号没了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 19 13:10:00 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031345, encodeId=a6f810313451b, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Tue Jan 19 02:45:49 CST 2021, time=2021-01-19, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2079101, encodeId=5bc820e910122, content=<a href='/topic/show?id=8fdb542e29e' target=_blank style='color:#2F92EE;'>#房颤消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54272, encryptionId=8fdb542e29e, topicName=房颤消融)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Wed Sep 29 09:45:49 CST 2021, time=2021-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918740, encodeId=ef53918e40e1, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210124/2959859c08784950bc188459d8d7c2c1/3509ed0b3e3e4ca08f78e8a9232d2e4c.jpg, createdBy=24f61480129, createdName=小豁牙, createdTime=Thu Jan 21 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topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597758, encodeId=46ea159e7583b, content=<a href='/topic/show?id=28986582e02' target=_blank style='color:#2F92EE;'>#消融治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65827, encryptionId=28986582e02, topicName=消融治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f07818523366, createdName=zhishijing, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622467, encodeId=d420162246e16, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918036, encodeId=624a918036fc, content=有梅斯医学真好。可惜我之前的账号没了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 19 13:10:00 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031345, encodeId=a6f810313451b, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, 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  8. 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  9. 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    2021-01-19 1257c336m18暂无昵称

    有梅斯医学真好。可惜我之前的账号没了

    0

  10. 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style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Jan 20 14:45:49 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918036, encodeId=624a918036fc, content=有梅斯医学真好。可惜我之前的账号没了, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 19 13:10:00 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031345, encodeId=a6f810313451b, content=房颤,临床上碰到很多哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=心介, createdTime=Tue Jan 19 02:45:49 CST 2021, time=2021-01-19, status=1, ipAttribution=)]
    2021-01-19 心介

    房颤,临床上碰到很多哦

    0

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